Myocarditis means infection or inflammation of heart muscle (“myocardium”), which makes it difficult to pump blood. Sometimes the heart gets better, sometimes there’s permanent lifelong damage. The disease is uncommon, but tragic when it strikes an otherwise-healthy young person, who may then become severely disabled. It most commonly occurs between 20 and 50 years-old.
The most common cause is one of many viruses. But some cases of myocarditis may be due to certain bacteria (brucella, syphilis, mycoplasma, Lyme, etc. etc.), fungi, parasites (especially Chagas disease in people who’ve lived in Central and South America), worms, toxins (alcohol, poisons, cocaine, etc.), medications, and other diseases. See our discussion of Germs in general.
The main symptom to alert us is new onset shortness of breath, especially while walking. Occasional patients may have chest pain. On physical exam there may be typical findings of Heart Failure; but Heart Attacks would be rare. An EKG usually shows some abnormalities, chest-x-ray may show an enlarged heart. The best tests are a blood test called B-type natriuretic peptide (BNP), and especially an echocardiogram. In rare cases, a heart biopsy may be useful if diagnosis is uncertain and the condition is severe.
Treatment is the same as is usually given to anyone with Heart Failure. Most cases are caused by viruses, which have no specific treatment. But if an unusual germ or other cause is responsible, there may be special medications or other therapies available.